Recruitment and enrollment of rural and urban medically underserved elderly into a randomized trial of telemedicine case management for diabetes care.

Our goal was to identify reasons for enrollment or refusal to participate in a randomized trial of telemedicine case management of diabetes We performed a prospective survey of participants and non participants during recruitment for the Informatics for Diabetes Education and Telemedicine IDEATel study a randomized trial of telemedicine case management of diabetes mellitus in medically underserved elderly There were two recruitment areas urban New York City and rural upstate New York A Participant Questionnaire PQ was administered at the baseline IDEATel visit and a Non Participant Questionnaire NPQ was administered during the recruitment telephone call Both questionnaires listed possible responses subjects could choose more than one response or give their own Of 1 660 IDEATel participants 99 7 completed the PQ Most frequent reason for participation was the belief that the technology could help them 52 and 42 of urban and rural respondents respectively Of the 2 231 subjects refusing participation 28 answered the NPQ 90 of respondents were from rural area Most frequent reasons not to participate in the rural area were being too busy 23 and discomfort with the technology 22 and in the urban area the belief that the technology could not help them 71 discomfort with it 52 and not liking to participate in studies 52 In multivariate analysis rural respondents only knowing how to use a computer was an independent predictor of participation p Under 0 001 In conclusion perceptions and beliefs regarding technology including the expectation to benefit from it played an important role in the decision to participate